Yes and no. Is the horse likely to need a long period of stall rest, gradual return to turnout and riding - yes, absolutely. But most of newer treatments that you may want to consider depending on the diagnosis need to be put in or targeted at a specific location, including biologics (IRAP, PRP, Stem Cell, ProStride, etc.) and laser (and shockwave as you already mentioned). It may also tell you that there is no significant soft tissue damage, in which case you might go to a treatment like Tildren or Osphos, and substantially shorten the rest portion of the rehab.
1 Like
Well, we got the MRI results. Glad we did it. He has a significant core lesion to the DDFT that starts at the point of insertion and comes back out near the pastern (I may be using the wrong words… I’ve yet to see a report in writing, which is frustrating as I keep calling and asking for it since he had the MRI last Thursday). Significant adhesions in the navicular bursa as well. On the positive side – right front looks good, navicular bone itself looks good.
He struggled with anesthesia again. We will not lay this horse down again for anything other than an emergency. Not that he’s a good surgical candidate with this injury anyways. He came home and gas coliced within 4 hours of discharge, it’s been a rough few days (he’s totally fine now). Recommendation is stem cell treatment which are being harvested tomorrow and we will inject into the tendon sheath and navicular bursa (thanks Praetorian for still covering my 16 year old, accident prone horse) and lengthy stall rest with slow return to work. Also a shoeing change and brought the toes way back (went back in a 2 degree wedge, but an egg bar this time and he seems happy. Legs are cool and no swelling). Prognosis is not great, but we are throwing everything at it. This horse could care less about stall rest and is quiet and perfectly content as long as there is food in front of him.
We will see! Only time will tell.
4 Likes
Thanks for the update. I’m glad the MRI was able to give you an answer. Jingles for a good outcome.
1 Like
Medical reports are dictated and sent out for transcription, sometimes to foreign countries. You don’t get them in a few days. You’ll be lucky if you get them in a few weeks.
I’ve seen several other posts looking for info on soft tissue injuries here lately and thought I’d update mine.
We did 2 rounds of stem cell back in July and August. Ultrasounds were done approximately every 6 weeks until November. He was had a slow return to work and had been cleared to canter and return to his regular (very flat) pasture with one friend at the beginning of January. Prior to that, he spent the first 2 months after diagnosis on stall rest with hand walking (increasing time every week) and then got to go in a medical paddock (we increased time weekly). That was coupled with more hand walking, as he was not sane enough to tack walk. We started trotting in September - straight lines only… increasing time and eventually adding in turns of the arena over 10 weeks. Ultrasound after that also looked great.
He has been slightly lame over the past week at the trot. It’s minimal, but it’s there. He feels foot sore to me. We are going back to the vet school for another ultrasound Wednesday (he was due anyways), but I want to look at his feet and see if it’s time to change his shoeing.
I’m nervous what the results will tell me, but we have done everything possible for him. He’s happy, he’s currently fit and if we can get him 100% sound, I’d be thrilled. If not, I have retirement plans for him in place. This is the first soft tissue injury I’ve ever had to rehab and reading all of your stories on the forum has helped me more than you know — so thank you!
1 Like
Well, I will update mine, too… it seems to be the shoeing. I suspected he might have tripped hard enough to strain something like a collateral ligament, and with the new farrier he has been sound. We have brought him back slowly assuming he is also recovering from a strain of some sort. He is not a performance horse, but back to wtc and trails.
Hope this post doesn’t jinx it!
Were you able to get the horse sound? If so, what was the process?
Palm Beach-Yes I was able to get my horse sound, w/t/c and poles and lateral work and then we had another injury unrelated. It was very a long process…and exhausting.
He was 6 months on stall rest with hand walking, vibrating plate and shock wave therapy, massage therapy but the massage was not as often as I would have preferred due to crappy scheduling. He wore BOT quick wraps every night as well and I kept up with his Adequan regime and supplements.
Shoeing was really important, properly balanced feet for him.
He started tack walking after a follow up MRI at the beginning of April after the 6 months hand walking. I brought him home end of April and rehabbed him myself which was the best thing I could have done. Only worked on good footing.
I ended up walking for another 6 weeks before I started trotting due to hoof imbalance prior to my farrier fixing him up at home. Vet was out often for rechecks and input, lots of massage therapy, theraplate, magnetic booties, laser once per month. I am lucky and have a fantastic team around me at home.
He worked 7 days per week (I also hand walked him for 30-40 minutes and some hand grazing in the mornings, it was exhausting.) and he did not have turn out until he was w/t/c and lateral work and relatively fit. That was my decision because it was best for my horse.
Sample below that was sent from the MRI clinic for rehab. I modified it for my horse by basically adding another week or two on each recommended set depending on how he felt and I didn’t really add in the circles.
“Every session should begin with at least 15 minutes of walking to allow the tendon to warm up and develop appropriate level of flexibility. Since we are now increasing his workload, do not change any other aspect of his management (icing etc) so we can accurately monitor his response.
When increasing trot times, you can break them up into shorter sets and take 2-3 days to make the increase (for example, 7 minutes, then 8 then up to the full 9 minutes on consecutive days). He can hack on good footing any time and ideally works 6 days a week. This under saddle program should be on relatively firm footing, no mud or deep sand.
Week 1,2: 30 minutes total time under saddle (TTUS), 2 minutes of trotting, mainly limited to long sides, occasional short sides ok near the end of each week.
Week 3,4: 30 minutes TTUS, increase to 5 minutes of trot
Week 5,6: 35 minutes TTUS, increase to 7 minutes trot.
Week 7,8: 35 minutes TTUS, increase to 9 minutes trot. Increase short sides and introduce 20m circles
Week 9,10: 35 minutes TTUS, increase to 12 minutes trot
Week 11,12: 40 minutes TTUS, increase to 15 minutes trot
Week 13,14: 40 minutes TTUS, 18 minutes trot, occasional long side canter, smaller trot circles.
Week 15,16: 40 minutes TTUS, 21 minutes trot, occasional long side canter
Week 17,18: 45 minutes TTUS, 25 minutes trot, increase canter durations and introduce canter circles.”
I’m sure there’s more but it was awhile ago…I’d have to look at my notes.
I did not want to turn out as early as I did, but the horse was going to kill me under saddle. Even with drugs. He was trying really hard to behave but he was on the verge of blowing up every ride when we tried to canter. We’d ruled out pain and he was a gem to ride once he was turned out.
I am hoping we just need to revisit shoeing. He’s also 6 months out from one round of Osphos (which was done to address what changes we did see in the navicular bone, but who knows how long they’d been there). Hopefully tomorrow morning gives us a new plan. I had a meltdown yesterday over this. It wasn’t pretty or very mature. Time to get it together and take care of my horse.
Same injury on a 10 year old paint. after shoeing changes, injections and everything else made her worse…
I opted for excellent, excellent, excellent, took 4 farriers, excellent, JB approved trims from an excellent farrier (text book perfect hoof balance) and turned her out on a big, 15 acres, hilly pasture for 6 months to let her be a horse, followed by 6 months of sandy soil equally big pasture but with regular grooms, and sr feed fed daily. Horse recovered perfectly. On my vets advise we grounded her from jumping due to her foundation paint conformation though.
Is there any way you could let him go barefoot? I have a horse with similar symptoms. I kept him 2’6" sound by keeping him barefoot. I rode him in EasyBoot Gloves, and just took them off for showing. My pastures are grassy and soft, so he was fine being turned out barefoot. I will also comment that I keep my horses’ feet very dry – no standing in the wash rack, sponge off when necessary instead.
His diagnosis was “corns”. When his shoes were off, you could always see a little red mark on side of one heel right at the corner where the bars meet the hoof wall.
No to barefoot. It’s too rocky and while he does have good feet, they don’t hold up well when in regular work.
Ultrasound today was positive and what we can see of the lesion looks good. Obviously we cannot see down to P3, but he’s only intermittently lame going left on a circle at the trot (which is what we are seeing at home as well). We did block him, still blocks to the heel. We are going to repeat Osphos on Monday (he’s 6 months out from his last injection) and give him 3 weeks off post-Osphos. So a month in total off in case he tweaked something… then start slowly bringing him back. If he’s still slightly off, will redo hoof rads and see about shoeing changes. Good times. At least it’s winter.
Just another update to those that find themselves in the land of Google, trying to figure out what to do.
We were back jumping conservatively (once a week, if that and not hammering the jumps. He knows his job and we can fix me over poles). Horse showing (in long stirrup, but going to C and AA shows locally) and doing well. He pulled up lame about 3 weeks ago, felt behind but on further review with the vet school, in addition to advancement in his hock arthritis LH he has an acute injury to the lesion on his DDFT. Not bad, but NQR. Treated it with stem cells left over from last year.
He’s going to be taking it easy for the next year while I also have knee surgery. Tack walking, trail riding and some trotting to keep him moving. As soon as my surgeon releases me back to riding, we will try to more actively bring him back. Vet school seems positive that he’ll be fine. Who knows. I’ll let him guide the process with what he’s comfortable with!
2 Likes
Well, let me update, too.
New shoeing worked well for my guy and he was sound for a year, from mid 2018 to mid-2019.
Came up lame on RF in June, and time off didn’t work. Did ProStride, more time off, minimal improvement. Rads showed a navicular bone cyst, which he has had all along and been sound, but thinking maybe that was it, we did OsPhos and more time off.
I was then assuming a soft tissue injury and rather than MRI, gave it more time. (BTDT on MRI before with different horse!)
But at 3.5 months post injury, without the improvement I thought should have happened, I caved to the standing MRI this week.
Results: no navicular cyst! That was the most interesting, vet said it was an artifact on the xrays due to shape of his navicular bone. Otherwise, it was a collection of small tears, thickenings, scars, etc. Nothing that he said would individually cause lameness, but together must be responsible for his clinical lameness. (Not surprising, as this is an ex-ranch horse with wire cuts and scars everywhere - a rough life!) Vet also said it appeared “chronic” and this might be simply how he is… he didn’t think more time off would necessarily help.
I am hoping that the “chronic” part is just what appears when the MRI is done 3 months after the injury. We gave him a navicular bursa injection and will bring him back to work slowly. I have been tack-walking him 20 min a day for the last month, we will start to do a little more and see how it goes. I am just a trail rider, so even when back to work, it is a lot of walking.
OP, I’d not work the horse at all until you are recovered from your knee surgery.
Oh I haven’t had it yet! He’s alternating tack and hand walking (mostly with others… I’m lucky if I’m in town once a week right now due to work). I’m having surgery end of January 2020. Then I’m out of the tack 6-9 months depending on how my rehab goes.
For the past few days my guy has been sound (knock on wood). The direct bursa injection seemed to do the trick. Still bringing him back slowly, but there you go.
Hope everyone else is doing OK.
I’m glad that y’all have been coming back to update this thread! Good luck with your knee surgery.
Also, is standing MRI a common practice? I’ve only heard of MRI’s being done under general anesthesia.
You need a facility that HAS a standing MRI, but for issues below the fetlock, they seem to be well regarded. The only caveat I heard was that the weight of the horse standing compresses some anatomy and thus some small issues might be missed, that would be found on a traditional MR.
